Provider Demographics
NPI:1912433632
Name:CHEN, VICTOR ERIC (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:ERIC
Last Name:CHEN
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 DIVISADERO ST # H1031
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-3010
Mailing Address - Country:US
Mailing Address - Phone:415-353-7175
Mailing Address - Fax:415-353-9884
Practice Address - Street 1:1600 DIVISADERO ST # H1031
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-3010
Practice Address - Country:US
Practice Address - Phone:415-353-7175
Practice Address - Fax:415-353-9884
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD2099392085R0001X
CAA1999192085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500805046Medicaid